domingo, 21 de noviembre de 2010

A master from Germany

Un maestro de Alemania

  Karl Popper

Martin Heidegger 

I'm reading "A master from Germany" (R. Safransky), about the biography of Heidegger and his time.
The question is where could we find the relationship between this book and the prostate, since Heidegger's philosophy concerned about being and time?...well, something does, at least i thing so, let's tray to explain.
 As the scientist that i'd like to be (although perhaps doesn't arrive farther than a mere consumer of science), I worry about I'm reading  in scientific journals. They often publish studies of questionable reliability, as evidenced by the constant presence of contrary conclusions carried out by separate teams despite its apparent respect to the scientific method. The worry even increases wen some inconsistencies become a truly fashion among the medical community, inviting us to thing in a certain way, and just a few years later every thing changes and it's supposed that we should thing the contrary.
Well, as the philosophy has a section called epistemology, in order to figure out how to get the knowledge  with a certain degree of reliability, and one of the the most lucid writers on epistemology was K. Popper, in recent years I occasionally read this author. He taught me to distinguish what is known scientifically based, from matters merely intuited and published as if they were. Interestingly I learned more of how to do a rigorous and critical study in "The open society and its enemies", where Popper analyzes the human evil hidden under the respectable Plato's old look, than in "The logic of scientific discovery". Perhaps because i prefer about Popper his rigor and honesty, witch in the second book is just explained, but in the first widely used.
Yes, Popper, I mentioned him a philosopher that I knew  while drinking wines and he told me that he worked with Heidegger 50 years ago. I spoke about Popper because it was the only philosopher remembered enough by me to keep the conversation going, and remaining able to get surprised with something interesting. The man was dedicated to ontology, as Hiedegger was, whom he hated as a person but he admired as a thinker, a paradox hard to me to understand. Because I wanted to know from long time (Heidegger), i decided to buy "A master...".
Now I'm trying to empathize with the scholastics and Heidegger's tricks to make up the puzzle whose pieces are a doctoral dissertation, a reactionary education funded by the Catholics, some pitfalls to avoid going to war and a Jewish phenomenologist called Husserl.
And once again, What's the relationship of the above mentioned to the prostate? it is very clear: making something very, very complicated, threating with illness and death and then showing the silver bullet. This is very well explained by Popper: if you know the reasons why a man develop philosopher and write, you will be able to guess what he writes before you read it, as well, if you know the reasons why some american urologist urged to investigate the healthy prostates you will be able to understand why they are still keeping on recommend, though it is useless.

Racionalism or freedom

Racionalismo o libertad.
Developments in culture, science or technology are usually associated with improvements. Because of that, i wonder the story of John Ruskin (1819-1900), which criticized the  social progress on renaissance compared to the medieval individualism. He glazed two buildings at the Piazza San Marco, in Venice, one with irregularities in each column, where every window was different from each other one due to occurrences of the worker that placed the bricks, and compared it with the newer building across, subject to the advanced architectural standards that were imposed to each worker by the architect on a regular and predictable way. According to Rusking the architecture progressed, the owner of the building was happier, and perhaps the architect too, but the Renaissance submitted the will, creativity and thus the freedom of hundreds of workers who could not finish off the bricks as they would like. Summary: the gothic beauty of improvisation were annulled and replaced by an alienating mechanicism imposed in the renaissance.
But I've being thinking till now, that the individual freedom increased progressively from the middle age to our days, being the use of reason its strongest ally. However i have to recognize that the things that made me happy were the adventure, the poetry, the music and the explosion of feelings claimed by Rusking and the romantics instead of mathematics and anatomy.
In fact, the rationalism gives us tools to survive better in the nature, but the romanticism exalt the feelings that make us happy. Study science enables us to understand how the universe works, but the paintings of Turner evokes the emotions that justify our life.
Just as science teaches us how we get sick and how we die. Just as science show us the ways to overcome the disease or replace it with the treatment side effects, the artists keep on inspiring the feelings that make easier our happiness. Is only our individual freedom which have to choice every time between the options: the chance of healing or the chance of feeling.
Facing a prostate cancer, the science propose alternatives without the pressure of others cancers that kill or heal with a big amount of certainty. In this disease, the reason fall humiliate by a virtual being that the patient doesn't  suffer with pain. Individual freedom have to wake up to decide about the own life over the social pressure. As Rusking aware that industrialization sweetened the life of a few bourgeois, at the expense of workers freedom, the social system push to consume rational medicine according to the standard pathways without considering the individual feelings.
In the case of patients with prostate cancer, a discussed and miserable cure rate is offer over some extra years of sexual enjoyment

martes, 16 de noviembre de 2010

Perplexity

Every time I attend a man who discovered an elevated PSA  by "accident", then suffered a prostate biopsy, and were shocked by the word cancer as it was written in the pathological report, once there are not chance for more delays and I must to inform him about the treatment, I wonder How will I be able to convey the advantages and disadvantages of each alternative. Resignedly, I begin my explanation like this: "you can be operate to remove the prostate, you can receive radiation therapy or you can avoid any kind of treatment." Then, i follow trying to argue that the differences, in terms of survival or at least in terms of quality of life, between the three alternatives are very low and the reliability of the studies that illustrate these small differences are also very weak.During the explanation, the reasons why i decided to become a surgeon fall collapsed. I dreamed to meet real patients with clearly effective treatments, instead of that I am faced with microscopic disease and treatments that nobody can clearly prove if improve or worse the life of anybody.

Skepticism about the cancer definition

Considering that the cancer is basically a fleshy bulk that growths, invade tissues and send metastases, how it's possible to diagnose a cancer when we only see an apparently healthy organ, without anything growing inside, with everything working well, an no metastases in the scans, only because of the findings in the biopsy?